Jack Rutledge Winters, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00006080 Issued in WA

Practice address

2102 N Pearl Street
Suite 206
Tacoma, WA 98406

Phone

(253) 756-1600

Fax

(253) 756-1668

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841333176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 N PEARL STREET",
            "address_2": "SUITE 206",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98406",
            "telephone_number": "253-756-1600",
            "fax_number": "253-756-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 N PEARL STREET",
            "address_2": "SUITE 206",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98406",
            "telephone_number": "253-756-1600",
            "fax_number": "253-756-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTERS",
        "first_name": "JACK",
        "middle_name": "RUTLEDGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Winston-Heath, ARNP
• Andre Lavell Winston Jr.
• Christina Winterburn-Cassavant, DPT
• Donna Gayle Winters, R.N-BSN
• Emily Jayne Winters, MA, CCC-SLP
• Wayne F Winters
• Lisa Elaine Wire
• Candy Wirges, LPN
• Gabrielle Hannah Wirick, PT, DPT
• Lindsey Wisdom, RDH

• General Practice Dentistry in Tacoma, WA
• Providers in Tacoma, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.